﻿<br />
<div  class="orderHeader">
    <table style="width: 100%; border: 0;">
        <tbody>
            <tr>
                <td style="width: 50%" rowspan="3">
                    <span class="circle1">•</span>&nbsp;Provisional<br>
                    <span class="circle2">•</span>&nbsp;Engineer&nbsp;checked&nbsp;&nbsp; <span class="circle3">
                        •</span>&nbsp;Credit&nbsp;approved<br>
                    <span class="circle6">•</span>&nbsp;Sales&nbsp;Confirmed&nbsp;&nbsp; <span class="circle4">
                        •</span>&nbsp;Ship&nbsp;approved&nbsp;&nbsp;
                </td>
                <td style="width: 25%; text-align: right;">
                    <label for="CustomerPONo">
                        Your Purchase order or reference number</label>
                </td>
                <td style="width: 25%">
                    <input type="text" value="LOGO" name="CustomerPONo" id="CustomerPONo">
                </td>
            </tr>
            <tr>
                <td align="right">
                    <label for="OrderDate">
                        Order Date</label>
                </td>
                <td>
                    <input type="text" value="19-Jul-2011" readonly="readonly" name="OrderDate" id="OrderDate">
                </td>
            </tr>
            <tr>
                <td align="right">
                    <label for="JobNo">
                        CSF Job #</label>
                </td>
                <td>
                    <input type="text" value="SF0014" name="JobNo" id="JobNo">
                </td>
            </tr>
        </tbody>
    </table>
    <table style="width: 100%; border: 0;">
        <tbody>
            <tr>
                <td width="50%">
                    <table width="100%" style="background-color: #99ccff; border: 5px solid #99ccff;"
                        id="shippingTable">
                        <tbody>
                            <tr>
                                <td>
                                    <label for="ShipToName">
                                        Deliver to:</label>
                                </td>
                                <td>
                                    <input type="hidden" value="10016" name="ShipTo" id="ShipTo">
                                    <input type="text" value="Blancomar Nautica S.L" name="ShipToName" id="ShipToName"
                                        class="ui-autocomplete-input" autocomplete="off" role="textbox" aria-autocomplete="list"
                                        aria-haspopup="true">
                                    <a style="font-family: Webdings" href="#getCompanyList" id="SelectShipToName">
                                        <input type="button" value="▼"></a>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="ShipToAddress">
                                        Address:</label>
                                </td>
                                <td>
                                    <textarea rows="7" name="ShipToAddress" id="ShipToAddress" cols="30">C/ Santiago no109
Tenerife, Canary Islands, Spain</textarea>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="ShipToZipCode">
                                        ZIP Code:</label>
                                </td>
                                <td>
                                    <input type="text" value="38001" name="ShipToZipCode" id="ShipToZipCode">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="ShipToPhone">
                                        Tel No:</label>
                                </td>
                                <td>
                                    <input type="text" value="0034922597082" name="ShipToPhone" id="ShipToPhone">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="ShipToFax">
                                        Fax No:</label>
                                </td>
                                <td>
                                    <input type="text" value="0034922279769" name="ShipToFax" id="ShipToFax">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="ShipToContact">
                                        Contact</label>
                                </td>
                                <td>
                                    <input type="text" value="Jose Antonio Fernandez Ibars" name="ShipToContact" id="ShipToContact">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="ShipToEmail">
                                        Email:</label>
                                </td>
                                <td>
                                    <input type="text" value="joseibars@neilprydesail.es" name="ShipToEmail" id="ShipToEmail">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="VatNo">
                                        EIN or Tax No:</label>
                                </td>
                                <td>
                                    <input type="text" value="B38708342" name="VatNo" id="VatNo">
                                </td>
                            </tr>
                        </tbody>
                    </table>
                </td>
                <td>
                    <table width="100%" style="background-color: #ffffff; border: 5px solid #ffffff;"
                        id="Table1">
                        <tbody>
                            <tr>
                                <td>
                                    <label for="BillToName">
                                        Bill to:</label>
                                </td>
                                <td>
                                    <input type="hidden" value="10016" name="BillTo" id="BillTo">
                                    <input type="text" value="Blancomar Nautica S.L" name="BillToName" id="BillToName"
                                        class="ui-autocomplete-input" autocomplete="off" role="textbox" aria-autocomplete="list"
                                        aria-haspopup="true">
                                    <a href="#getCompanyList" id="SelectBillToName">
                                        <input type="button" value="▼"></a>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="BillToAddress">
                                        Address:</label>
                                </td>
                                <td>
                                    <textarea rows="7" name="BillToAddress" id="BillToAddress" cols="30">C/ Santiago no109
Tenerife, Canary Islands, Spain</textarea>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="BillToZipCode">
                                        ZIP Code:</label>
                                </td>
                                <td>
                                    <input type="text" value="38001" name="BillToZipCode" id="BillToZipCode">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="BillToPhone">
                                        Tel No:</label>
                                </td>
                                <td>
                                    <input type="text" value="0034922597082" name="BillToPhone" id="BillToPhone">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="BillToFax">
                                        Fax No:</label>
                                </td>
                                <td>
                                    <input type="text" value="0034922279769" name="BillToFax" id="BillToFax">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="BillToContact">
                                        Contact</label>
                                </td>
                                <td>
                                    <input type="text" value="Jose Antonio Fernandez Ibars" name="BillToContact" id="BillToContact">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <label for="BillToEmail">
                                        Email:</label>
                                </td>
                                <td>
                                    <input type="text" value="joseibars@neilprydesail.es" name="BillToEmail" id="BillToEmail">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                </td>
                                <td>
                                </td>
                            </tr>
                        </tbody>
                    </table>
                </td>
            </tr>
        </tbody>
    </table>
    <br>
    <table style="width: 100%; border: 0;">
        <tbody>
            <tr>
                <td width="15%">
                    <label for="DeliveryModeCode">
                        Delivery method</label>
                </td>
                <td width="45%">
                    <input type="radio" value="UP" name="DeliveryModeCode" id="DeliveryModes0">&nbsp;UPS&nbsp;&nbsp;&nbsp;&nbsp;
                    <input type="radio" value="SE" name="DeliveryModeCode" id="DeliveryModes1">&nbsp;FedEx&nbsp;&nbsp;&nbsp;&nbsp;
                    <input type="radio" value="AR" name="DeliveryModeCode" id="DeliveryModes2">&nbsp;Air&nbsp;&nbsp;&nbsp;&nbsp;
                    <input type="radio" value="OT" name="DeliveryModeCode" id="DeliveryModes3">&nbsp;Other&nbsp;&nbsp;&nbsp;&nbsp;
                </td>
                <td width="15%">
                    <label for="DeliveryTrackNo">
                        Tracking #</label>
                </td>
                <td>
                    <input type="text" value="" name="DeliveryTrackNo" id="DeliveryTrackNo">
                </td>
            </tr>
            <tr>
                <td>
                    Delivery Terms
                </td>
                <td style="color: Red; font-weight: bold;" colspan="3">
                    DDU (delivered price with duty and VAT not paid)
                </td>
            </tr>
            <tr>
                <td>
                    <label for="DeliveryDate">
                        Delivery required</label>
                </td>
                <td>
                    <input type="text" value="24-Jul-2011" readonly="readonly" name="DeliveryDate" id="DeliveryDate"
                        placeholder="Generated automatically">
                </td>
                <td>
                    <label for="DeliveryWeek">
                        Delivery Week #
                    </label>
                </td>
                <td>
                    <input type="hidden" value="2011" name="DeliveryYear" id="DeliveryYear"><input type="text"
                        value="30" name="DeliveryWeek" id="DeliveryWeek">
                </td>
            </tr>
        </tbody>
    </table>
</div>
<hr style="width: 740px;" />
